{
  "resourceType": "StructureDefinition",
  "id": "NHSEngland-Composition-GenomicsEULabReport",
  "url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-Composition-GenomicsEULabReport",
  "version": "0.3.0",
  "name": "NHSEngland_Composition_GenomicsEULabReport",
  "title": "NHSEngland Composition GenomicsEULabReport",
  "status": "active",
  "date": "2026-04-16",
  "publisher": "NHS England",
  "contact": [
    {
      "name": "NHS England",
      "telecom": [
        {
          "system": "email",
          "value": "interoperabilityteam@nhs.net",
          "use": "work",
          "rank": 1
        }
      ]
    }
  ],
  "description": "This profile defines the Genomics constraints and extensions on the EU Lab FHIR resource [EU Lab Composition](http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab).",
  "purpose": "There are two use cases for Compositions within Genomics.\r\n\r\nFor Order Management, Compositions will be limited to documents generated by the central broker for capturing snapshots of Test orders and results in order to maintain historical accuracy, as per the DocumentReference generate OperationDefinition. These will typically form the first entry of a Document Bundle and as such will not be exposed via their own endpoint, nor allow creates, reads or updates from client systems on the resource itself.\r\n\r\nTo support cross border data sharing Compositions MAY be aligned to the HL7 EU Lab Composition profile as a wrap around structured reports.\r\n\r\nFor the Unified Genomic Record, Compositions will form the header or 'contents page' of the UGR itself. section elements will be used to emulate the UGR folders. ",
  "copyright": "Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\\\\\"License\\\\\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at  http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\\\\\"AS IS\\\\\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at  https://www.hl7.org/fhir/license.html.",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Composition",
  "baseDefinition": "http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Composition.extension:basedOn-order-or-requisition",
        "path": "Composition.extension",
        "sliceName": "basedOn-order-or-requisition",
        "definition": "TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: Composition Profile). A reference to the ServiceRequest which this report is in response to."
      },
      {
        "id": "Composition.extension:basedOn-order-or-requisition.value[x]:valueReference",
        "path": "Composition.extension.value[x]",
        "sliceName": "valueReference",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSEngland-ServiceRequest-Genomics",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"
            ],
            "aggregation": [
              "referenced",
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.extension:information-recipient",
        "path": "Composition.extension",
        "sliceName": "information-recipient",
        "definition": "TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: Composition Profile). A reference to the recipient for a report, could potentially be used to reference additional recipients over the subject and original requester for the request."
      },
      {
        "id": "Composition.extension:information-recipient.value[x]",
        "path": "Composition.extension.value[x]",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/Practitioner-eu-lab",
              "http://hl7.org/fhir/StructureDefinition/Device",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/PractitionerRole-eu-lab",
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ],
            "aggregation": [
              "referenced",
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.extension:diagnosticReport-reference",
        "path": "Composition.extension",
        "sliceName": "diagnosticReport-reference",
        "definition": "TBC. Only relevant for EU Lab aligned reports (included in HL7 EU Laboratory Report: Composition Profile). A reference to the focal DiagnosticReport this Composition is for."
      },
      {
        "id": "Composition.extension:diagnosticReport-reference.value[x]",
        "path": "Composition.extension.value[x]",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSEngland-DiagnosticReport-GenomicReport",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab"
            ],
            "aggregation": [
              "referenced",
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.status",
        "path": "Composition.status",
        "definition": "Fixed value of 'final'",
        "fixedCode": "final"
      },
      {
        "id": "Composition.type",
        "path": "Composition.type",
        "definition": "SNOMED CT code for either a Laboratory Request (24691000000102) or Genetic report (1054161000000101)"
      },
      {
        "id": "Composition.type.coding",
        "path": "Composition.type.coding",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "$this"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Composition.type.coding.display.extension:translation",
        "path": "Composition.type.coding.display.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.type.coding.display.extension:translation.extension",
        "path": "Composition.type.coding.display.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.type.coding:codingGenomics",
        "path": "Composition.type.coding",
        "sliceName": "codingGenomics",
        "fixedCoding": {
          "system": "http://snomed.info/sct",
          "code": "1054161000000101",
          "display": "Genetic report"
        }
      },
      {
        "id": "Composition.type.coding:codingGenomics.display.extension:translation",
        "path": "Composition.type.coding.display.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.type.coding:codingGenomics.display.extension:translation.extension",
        "path": "Composition.type.coding.display.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.type.text.extension:translation",
        "path": "Composition.type.text.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.type.text.extension:translation.extension",
        "path": "Composition.type.text.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.category",
        "path": "Composition.category",
        "slicing": {
          "rules": "open"
        },
        "definition": "Fixed codes for conformance to the EU Lab Composition profile (for cross border sharing of lab reports)."
      },
      {
        "id": "Composition.category.coding.display.extension:translation",
        "path": "Composition.category.coding.display.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.category.coding.display.extension:translation.extension",
        "path": "Composition.category.coding.display.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.category.text.extension:translation",
        "path": "Composition.category.text.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.category.text.extension:translation.extension",
        "path": "Composition.category.text.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.category:studyType",
        "path": "Composition.category",
        "sliceName": "studyType",
        "fixedCodeableConcept": {
          "coding": [
            {
              "system": "http://loinc.org",
              "code": "26436-6",
              "display": "Laboratory studies (set)"
            }
          ]
        }
      },
      {
        "id": "Composition.category:specialty",
        "path": "Composition.category",
        "sliceName": "specialty",
        "fixedCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "1236877003",
              "display": "Genetic pathology"
            }
          ]
        }
      },
      {
        "id": "Composition.subject",
        "path": "Composition.subject",
        "definition": "Matches subject reference included in either the DiagnosticReport or ServiceRequest",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab",
              "http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-animal-eu-lab",
              "http://hl7.org/fhir/StructureDefinition/Group",
              "http://hl7.org/fhir/StructureDefinition/Location",
              "http://hl7.org/fhir/StructureDefinition/Device"
            ],
            "aggregation": [
              "referenced",
              "bundled"
            ]
          }
        ]
      },
      {
        "id": "Composition.date",
        "path": "Composition.date",
        "definition": "SHALL be the dateTime the Composition was generated by the central broker"
      },
      {
        "id": "Composition.author",
        "path": "Composition.author",
        "definition": "Fixed to an identifier for the central broker (TBC). The author for the underlying ServiceRequest or DiagnosticReport can be retrieved by interrogating the appropriate resources."
      },
      {
        "id": "Composition.title",
        "path": "Composition.title",
        "definition": "SHALL match the SNOMED CT display used within Composition.type",
        "fixedString": "Genetic report"
      },
      {
        "id": "Composition.section",
        "path": "Composition.section",
        "slicing": {
          "rules": "open"
        },
        "definition": "To conform to EU Lab, SHOULD include references to the results that form part of the genomic report. For the UGR, will include sections that conform to the UGR folders, this work is currently in development."
      },
      {
        "id": "Composition.section.code.coding.display.extension:translation",
        "path": "Composition.section.code.coding.display.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.section.code.coding.display.extension:translation.extension",
        "path": "Composition.section.code.coding.display.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.section.code.text.extension:translation",
        "path": "Composition.section.code.text.extension",
        "sliceName": "translation"
      },
      {
        "id": "Composition.section.code.text.extension:translation.extension",
        "path": "Composition.section.code.text.extension.extension",
        "min": 2
      },
      {
        "id": "Composition.section:sectionUGR",
        "path": "Composition.section",
        "sliceName": "sectionUGR",
        "definition": "Sections included within the UGR: patient-demographics | investigations-and-procedures-requested | investigation-results | consent-for-information-sharing |  family-history "
      },
      {
        "id": "Composition.section:sectionUGR.code",
        "path": "Composition.section.code",
        "binding": {
          "strength": "extensible",
          "description": "UK Core Composition Section Codes",
          "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-CompositionSectionCode"
        }
      }
    ]
  }
}